Non-Injection Routes of Immunotherapy
ÎAllergen extracts can be administered through several routes in addition to the subcutaneous route. Currently, there are no FDA- approved formulations for a noninjection immunotherapy extract. (A)
ÎRandomized controlled clinical trials with dust mite and pollen sublingual immunotherapy have demonstrated significant improvement in symptoms and medication use in patients with allergic rhinitis and asthma. (A)
Adverse reactions to SLIT
ÎLocal reactions, primarily oral mucosal, are common with sublingual immunotherapy. Systemic reactions can occur, and a few reported cases have been of a severity to be categorized as anaphylaxis. A few patients who have systemic reactions to subcutaneous immunotherapy have also had systemic reactions to sublingual immunotherapy. (A)
ÎMost clinical trials evaluating the safety and efficacy of sublingual immunotherapy for patients with ragweed- and grass pollen-induced allergic rhinitis used a single allergen extract. Currently, there are no FDA-approved formulations for sublingual immunotherapy. (A)
Intranasal Immunotherapy
ÎRandomized controlled studies have demonstrated that nasal immunotherapy with dust mite and pollen extracts is effective in reducing symptoms and medication use. Local adverse reactions are common with this approach and are the most frequently cited reason for discontinuation of treatment in one large prospective study. The use of this approach has decreased considerably since the introduction of SLIT. (C)
Intralymphatic
ÎA 3-injection course of intralymphatic immunotherapy was as effective as a 3-year course of conventional subcutaneous immunotherapy in a noncontrolled study. (NR)
Epicutaneous
ÎEpicutaneous [patch] immunotherapy resulted in significantly higher treatment success in a placebo-controlled study. However, there were no significant differences in the primary outcome and nasal provocation test scores between the groups. (NR)
Oral immunotherapy and SLIT for food hypersensitivity
ÎSeveral clinical trials with oral and sublingual immunotherapy demonstrate an increased tolerance to oral food challenge in subjects with food hypersensitivity while receiving therapy. Oral and sublingual food immunotherapy is investigational. (NR)
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